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Objective To report a case of non-exertional heatstroke presenting as new encephalopathy in a patient with concomitant COVID-19 infection and Vibrio colitis.Methods Case study.Results A 78-year-old previously well male was found obtunded, tachycardic, hypotensive, and hyperthermic (40°C) in his home sauna. He was intubated with a Glasgow Coma Score of 3, admitted to the ICU, and required vasopressor support.Investigations included a septic screen and a lumbar puncture, which excluded bacterial and viral meningoencephalitis. He tested positive for COVID-19, and Vibrio vulnificus was found in his stool culture, although procalcitonin and infective markers were normal on admission. A CT stroke series showed non-specific ventriculomegaly, and an EEG indicated non-specific encephalopathy with increased slower rhythms.The patient was managed supportively with IV paracetamol for pyrexia and was empirically treated with ceftriaxone, benzylpenicillin, and acyclovir for possible meningoencephalitis. His ICU stay was further complicated by ischaemic hepatopathy, acute kidney injury, rhabdomyolysis, and disseminated intravascular coagulopathy, even though his core temperature normalised.With supportive management, he gradually improved, was extubated, and was discharged three weeks later without lateralising neurological signs and at baseline function.Conclusion While encephalopathy has been noted as a symptom of heatstroke in case studies, this case highlights the challenges of diagnosing it during concomitant infections. Heat stress can often mimic sepsis, due to peripheral blood shunting and cytokine release. Accurate diagnosis is crucial, as pharmacological therapies, for infection-driven pyrexia, may paradoxically worsen hepatic injury.